THE INCIDENCE OF URINARY TRACT INFECTION AMONG PATIENTS TREATED WITH VARIABLE DOSES OF DAPAGLIFLOZIN: A COMPARATIVE STUDY.

BACKGROUND

The Kidney plays a vital role in regulating glucose homeostasis through various mechanisms; one such mechanism involves glucose filtration and reabsorption. In a healthy individual, both kidneys filtrate about 180 grams of glucose daily; all of this filtrated glucose is reabsorbed in proximal tubules through sodium-glucose cotransporter 1 and 2 (SGLT1 and SGLT2). In diabetic patients, the plasma glucose level increases, which will lead to a rise in glucose filtration to exceed the reabsorption capacity of SGLT and hence glucosuria. SGLT2 expression is increased in patients with diabetic type 2. This leads to an increase in renal threshold of glucose from 180mg/dl in healthy individuals to 220 mg/dl in diabetic patients, which consequently leads to an increase in plasma glucose level. SGLT2 inhibitor, also known as (gliflozin), lowers plasma glucose and Hb1AC by increasing renal glucose excretion through inhibition of renal glucose reabsorption without causing hypoglycemia it has a modest glycemic control effect.

OBJECTIVES

To compare the incidence and severity of UTI in patients treated with different doses of dapagliflozin and to evaluate whether high doses have a greater risk of UTI.

SUBJECTS AND

METHODS

This study was conducted as a retrospective study involving a total of 100 patients diagnosed with type 2 diabetes mellitus, all of whom were treated at AL Diwaniyah teaching hospital. The participants were categorized into two groups: the first group received 10 mg of dapagliflozin, while the second group was administered 5 mg. To be included in this study, the patients had to be first prescribed either Dapagliflozin 10 mg or Dapagliflozin 5 mg during the period of 1 January 2024 to 30 June 2024. Participants were not eligible for inclusion if they were receiving insulin therapy, had incomplete medical records, died during the study period, or did not respond to telephone contact

Results

Both the 5 mg and 10 mg groups of Dapagliflozin have a similar clinical and demographic profile, with a higher prevalence of aged, female, and hypertensive individuals. Dapagliflozin's cardiometabolic benefits are consistent with its predominantly hypertensive status, but the larger percentage of smokers may suggest a link between smoking and the circumstances that call for it. Overall, most features of the two groups are similar, with the 10 mg group having somewhat more patients in the 50-60 age range and more females. This study found that Urination frequency is higher in the group taking 10 mg of dapagliflozin (~55%) than in the group taking 5 mg (~25%). Additionally, the 10 mg group experienced a greater level of urgency to pee (~48%) than the 5 mg group did (~20%). About 15% of the 10 mg group and 7-8% of the 5 mg group experienced dysuria, or unpleasant urination, which is the least common symptom. Regarding frequency and urgency, there are statistically significant differences (P<0.01). While regarding dysuria, the difference doesn't reach the significance limit (P=0.07).

CONCLUSION

The findings show persuasive evidence of a dosage-dependent rise in urinary tract infection signs in dapagliflozin-treated individuals, particularly at the 10 mg dose. The findings emphasize the importance of doctors closely monitoring patients for indications of genitourinary infections, specifically those receiving greater dosages. Because glycosuria plays an important role in raising infection risk, lower dosages or alternative therapy may be considered for individuals who are more likely to develop UTIs. Further research is needed to investigate long-term treatment techniques that maintain glycemic control and infection prevention in dapagliflozin patients.